Many of you may already have seen the first article in our December issue, "Documenting the Individual- and Household-Level Cost of Unsafe Abortion in Uganda," (click here for the news release), by Aparna Sundaram et al.



According to "Understanding Couples' Relationship Quality And Contraceptive Use in Kumasi, Ghana," by Carie Muntifering Cox of the University of Seattle, et al., the quality of a couple's relationship is linked to their contraceptive use. In analyses of 2010 survey data from 698 married or cohabiting couples, the more satisfied women were with their relationships, the more likely they were to use contraceptive methods that both partners are typically aware of (such as withdrawal, condoms, spermicide) than to use no method. The more strongly men felt that they were in a relationship with respectful communication, the more likely their partners were to use methods that both partners would typically be aware of or methods that a woman could use without her partner's knowledge rather than no method. The researchers advise that family planning programs consider the connection between relationship quality and contraceptive use when they target men and women, individually or as a couple. They also recommend that media campaigns about contraceptives integrate messages about healthy relationships.


According to "Consumer Perspectives on a Pericoital Contraceptive Pill In India and Uganda," by Jane K. Cover of PATH, Seattle, WA, USA, et al., a contraceptive pill that could be taken on demand could appeal to a wide range of women in different settings, particularly those who have sex infrequently. The researchers conducted 39 focus groups and 23 in-depth interviews in Kampala, Uganda, and Lucknow, Uttar Pradesh, India, to understand the potential market for an on-demand pill. In both countries, participants viewed the product favorably largely because it would be easier then taking a daily pill and could be taken discreetly without a partner's knowledge. The authors note that some differences did emerge between the two countries. In Uganda, where partner opposition to contraception is high, discretion emerged as a prominent advantage. By contrast, effectiveness was a greater concern for women in Lucknow, where unintended pregnancy among unmarried women often has serious social consequences.


According to "The Oportunidades Conditional Cash Transfer Program: Effects on Pregnancy and Contraceptive Use Among Young Rural Women in Mexico," by Blair Darney of University of Washington, Seattle, et al., a government program that gives money to wives and female household heads if they use health services and attend school is not independently associated with the reproductive behavior of rural adolescent and young adult women. Analyses of data from 2006 samples of young women with and without exposure to the program showed that having a secondary education, having ever been married and having access to health insurance—but not exposure to the government program—were linked to an increased likelihood of current contraceptive use. Further analysis showed that the program was indirectly linked, through promoting current school attendance, to a decreased likelihood of pregnancy in adolescents. The authors recommend that Mexico's family planning program focus on creating strategies to increase contraceptive use among young rural women, including those not enrolled in the program.


In "Reproduction, Functional Autonomy and Changing Experiences of Intimate Partner Violence Within Marriage in Rural India," by Christine Bourey of Emory University, et al., researchers used data from a sample of 4,749 married women in rural areas in four states in India who were interviewed in 1998–1999 and in 2002–2003 to investigate the relationship between changes in female autonomy and childbearing and changes in intimate partner violence in the 12 months before interview. Women who had continued freedom of movement and no change in financial autonomy had a lower risk of experiencing initiation of violence than of experiencing no violence. Women who reported that their economic contribution to the household decreased or increased and women who had an unwanted pregnancy had a higher risk of experiencing continued violence than of experiencing no violence. The authors note that future research to inform interventions to reduce partner violence should consider how changes in women's reproductive experiences and functional autonomy may be linked to changes in intimate partner violence.



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Researchers Posing as Clients Find Inadequate Contraceptive Care by Some Kenyan Providers